Systemic adenosine infusions alleviated neuropathic pain

A 15-year-old boy suffering from a degenerative neurometabolic disorder was treated in a palliative home care unit. Opioid administered by continuous intravenous infusion gave excellent relief from headache, muscle pain and pain from renal calculi. He continued to complain of burning pain in response to tactile stimuli. A prior quantitative sensory test had shown changes in sensation. Intravenous adenosine (ADO) infusions were given weekly. After 5 weeks of infusions, there was no recurrence of pain between treatments. ADO infusions were continued for 7 months without any side effects or signs of tolerance to the drug. There are indications that ADO may play a role as a modulator of neuropathic and nociceptive pain. In this case with pronounced allodynia, our interpretation is that neuropathic mechanisms were responsible and that ADO infusions played an important role in controlling pain.